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tv   [untitled]    January 18, 2014 3:00pm-3:31pm PST

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>> the commission, and the meeting is called to order at 5:33 p.m. up to roll call. >> commissioner adams? >> here. dooley >> here. white. >> here. >> yee rilely. >> we have a quorum.
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>> public comment *. >> anyone that would like to make a comment on anything that is not on today's ago ahead agenda. >> public comment is closed. >> we have one. >> gordon angle and we voend a property for 150 years and my family has lived in and around san francisco for almost 200 years, as far as we know we are the longest standing property owners and currently my 88-year-old grandmother is the deed owner and i hope it to be mine and i hope to pass it to my son. >> i began managing the building in mid 2010 and i came
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aware of major issues with the building and as well as the tenants and i immediately started working to plan a complete remodel of the building and i began looking for investors for an up scale lounge for the first floor and this space had previously been two units one a dive bar and a pointer shop, considering the depressed economy on the 400 and 500 blocks of brod kay, i knew that if we were going to be successful any tenants would have to attract a different dem graphic of customer than most of the businesses in the neighborhood. and in all, we are investing 2 and a half million dollars into our property. the establishment being proposed for the first floor which investor haves ear marked money for is to be called the
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trist lounge, it is going to be a high end lounge that is tar intelligented to professionals from the financial district as well as tourists. and we are planning on serving limited food service alongside the cocktail and beers and starting on the weekends and continuing into the evening this will make us unique in the neighborhood and there are no other bars that are open seven days a week. we also have plans for a sunday brunch service and i also secured a tenant for the second floor which is a green building contracting company. our progress is hampered by groups, and one of the groups that is opposed is the north beach business association which seems at odds with what the goals of what that
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organization should be. >> it has become an arm of the dwellers which is one of the anti-business groups in the city of san francisco and the culmination of the political shananagans that are effecting my project and our building is that our building has been empty and boarded up for the better part of two and a half years and this is devastating to my family, and especially my grandmother who is 88 years old. she is currently dealing with the fact that my9 2-year-old grandfather is in the final stages of terminal cancer and she has to worry that her financial future is in peril and if she has anything to give her xhirn and grandchildren. after two years of planning and fighting to try to get this
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project finished supervisor david chiu will begin moratorium, i can't help but think that this is partially in response to the project at my family's building, none of the people do not like the light that we have shown on them. >> okay, great. >> you three minutes, public comment. >> thank you. >> next speaker, please? >> good evening, commissioners, my nam is stefen ostalato and i am doing out reach and i am a well known figure down there and i am working with an attorney that is representing mr. jordan angle and his 88-year-old grandmother who would like to basically fix the building up, and open an ultralounge and i want to straes the moratorium issue and many people don't believe in moratoriums not for two seconds or two minutes or two hours or more or less two years that they are asking for.
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and the problem with moratoriums is that you have two long term vacantcies on that block, hellman and brandy ho and that was caused by the mountain that moved and shifted and which those buildings truly never recovered. this that will take into place, will freeze out the crow bar location, which is a large location which had a suiter that was going to invest a half million dollars and transfer the license to that space. and now, since it has lost interest because it cannot garner the support from some of the neighborhood groups or the people that are called stewards of broad way. and the other location site is the fuse location and that former site was an existing bar use, just like the crow bars less than three years and he can't get the support of some of the specific relevant or the significant folks over there. however, his grandmother wants to know why the lusty lady
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location, which in today's business times says that they are going to open a bar, type 48, with snacks across the street. and why the brian shehe described as a cocktail mogal, who happens to run a great business practice and happen to know and like what he does. and which wants to open a 256 columbus which so ever 3,000 and had a food component but it has been vacant since 2009. and many of us feel that we welcome the lusty lady location site because we know that the hammers will be responsible and we also welcome him coming in because he has a good track record and we also welcome the trist lounge because they have a good business plan and security plan and we feel that the crow bar location that had some entitlements would be more complete with a full liquor
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license and these locations will bring a better demographic and attract people like visitor and locals to want to come back to broad way. right now it is a junkyard and it is filled with those that come in from the east bay and none of the clubs have any entertainment permits and no checks and balances and in addition to that, we would recommend just like the mayor has inreinvested in the neighborhood, private capitol and fix the buildings up and create the business opportunity and make the business sustainable. >> thank you. >> any other public comment? >> seeing none, public comment is closed. next its em, please? >> bring us to item three, approval of the december 9, 2013 joint small business submission and san francisco transportation board of directors meeting minutes this is an action itment. >> do have have a motion to approve. >> move to approve. >> second. >> all in favor?
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>> aye. >> and any opposed? >> 4, approval of the december 9, 2013, special meeting. >> move to approve. >> second. >> all in favor. >> aye. >> item five, approval of the december, 20, 2013, special meeting minutes, action item. >> move to approve, >> second. >> all in favor? >> aye. >> any opposed, motion passes, next item please. >> item 6, discussion and possible action on overview of the final report of the universal healthcare council and updating reported requirements for the recent healthcare security ordinance or hcso and this is a discussion and possible action item and we have a presentation by the deputy director of health and san francisco department of health and the office of labor standard enforcement.
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>> we should... yeah. >> all of the lights are on. >> mike, well, any way, i will speak loud. so i just, i want to express my appreciation for you both collin and ellen love for being here this evening and present on this, the universal healthcare council concluded its meetings. the first part of december, and i really also also want to acknowledge colin chowla and amika chandry for the excellent work that they did in compiling the presentation materials, heftc challenge in trying to define the healthcare security ordinance, where it is, and how it works, and then, but even greater of a challenge is the affordable care act. and so, just really want to come mend them for the
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excellent job that they did and really sort of just going down some complex information for the council members. and in your packet is the final report, with the list of suggestions, but coleen is going to give a brief overview and kind of moving forward and then ellen will talk about the current faqs and compliance with the healthcare security ordinance. so, thank you. >> thank you very much. and good evening, commissioners and it is a pleasure to be here before you. and so i thought that would i give a brief presentation, and talk a little bit about the universal healthcare council and its findings, and the key findings and talk a little bit about the affordable care act and the healthcare security ordinance. and show you some data about the convergence of the two and then talk about compliance with both of the laws moving forward as far as businesses are
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concerned. >> and so the universal healthcare council was a 41 member body that was convened for a total of 5 meetings between september and december, the purpose of the council is to study the interaction of the affordable care act with the local healthcare security ordinance, and this is a reconstitution of the original group that came together in 2006 that created the healthcare security ordinance. and the final report by the council had two key findings which i will review in
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>> outpatient care and emergency care and hospitalization and maternity and newborn care and mental healthcare and it requires most everyone to have this health insurance. and some people are excluded. undocumented individuals are exclude and people with very, very low income are excluded from the mandate and people who are incarcerated or members of the american indian tribes are also excluded but for the most part it is the most people in the u.s.. and the proof of coverage is provided by the individual at the time of the federal income tax return and there are penalties that are assessed for people who are not compliant >> and on the second piece of aca, that provides more options for people to get health insurance, it does this and one of four ways. and the first is expanding medicare eligibility and for
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the people with incomes up to 15,800 for a single individual will be met, eligible for a publicly subsidized health insurance and it will be free and full insurance. the second way is through on-line insurance market place and this is coverage california and in california you have heard a lot of talk about the insurance market places at the federal level healthcare dot gov and run the exchanges for many states but not california, california has its own, coverage and on this website, individuals can purchase health insurance in san francisco they can choose from one of five health insurance plans that offer health insurance on the market that meet the standards that individuals are required to have. people who are low income, slightly higher than medical eligible levels and the subsidies to help to buy the insurance on the exchange, and that goes up to about,... now i am going to forget.
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45,000 or so for a single person. and it can be eligible for a subsidy >> the third way that the health reform makes it more accessible to people is through the employer sponsored coverage and i will go through these in more detail on the next slide and also the market reforms is the last way that people have more access to healthcare coverage and these are change to health insurance plans that make them more retain able for individuals and for example, people can't be denied health insurance coverage because they have a preexisting condition, and the people can't be dropped because they used too many services and so those market reforms help to retain the health insurance. >> and so the specific provisions that relate to employers, and there is not an employer mandate, but rather there is a penalty structure for large employers that do not comply with certain provisions of the aca. and there is an incentive structure for small employers to offer the health insurance.
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and so the large employers are those employers that have more than 50 ftes and they are required to provide affordable health insurance to more than 95 percent of the full time employees. and full time is defined as more than 30 hours a week. and if they don't comply with this provision, there may be penalties and the penalties accrue, beginning in 2015 and only if one of those employer's employees try to get a subsidy on the coverage california and so that is, if a large employer employee, is accessing a subsidy because they are low income and the employer does not provide health insurance then the employer will be penalized. for small employers, there is an incentive structure and so these are any employer who has fewer than 50 fte and there is no requirement to offer insurance, and they, there is a new, option on the coverage california website for the
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small businesses to purchase the health insurance and some businesses may be elible for a tax credit. tax credits for certain small employers that purchase, coverage through the coverage california, small business plan, are dependant on the plan and a number of factors including a number of ftes that the business have and the amounts that the employer contributes to the health insurance premiums and these tax credits are available for the two years that the employers want to claim them and they become and, they are available in 2013 and become more generous in 2014. and so for relatively low wage, very small, and for profit businesses those that have an average salary of 25,000 a year or less, and have fewer than ten ftes, the tax credit in 2013, is 35 percent of the employer's experience and in
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2014, is 50 percent of the employer's expense. for the small businesses with the slightly higher wages less than 50,000 and slightly larger sizes, less than 25 ftes, the credits are on the sliding scale, and the maximum is the same as the flat rate for the smaller businesses in the first line. they cover the employers to make the healthcare expenditures on behalf of the covered employees and on the slide, below the first large bullet is the definition of each of these terms.
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so covered employers are for profit companies that have 20 or more employees and non-profit companies that have 50 or more employees. and covered employees are employees that work at least 90 calendar days for the employer, and work at least 8 hours a week in san francisco, and the healthcare expenditures that covered employers must make on behalf of covered employees is the amount paid by an employer to provider reimburse for healthcare service and there is a minimum established every year and that is the total number of hours worked by the covered employee, times $1.63 per hour for medium employers and 2.44 for large employers. >> and so that is what the healthcare security requires to be spent on healthcare for original employees. and separately, the healthcare security ordinances created the healthy san francisco program and this is a health access
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program for uninsured san francisco and i will talk about that more in a minute. >> so, this is a chart that shows the common ways that employers complied with the healthcare security ordinance before the aca. and so if you look at the top box, the employer's spending requirement, and the employer spending requirement applies to entities, or non-profit for 50 or more employees and they make the expenditures on behave of the employees working 8 hours or more per week. and there are many ways that business cans comply but there are three primary ways that they tend to comply and the first one in the middle is through health insurance and most businesses purchase, health insurance on behalf of their employees to comply with the healthcare security ordinance. another way is the hra. hra stands for the health
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reimbursement account. and that is a stand alone account from which that is administered by the employer, employees can draw down allowable expenses to draw down on that account and the employers can set the terms of what can be covered by that account. and then, unused funds, revert to the employer after 24 months of inactivity. and that one, i will highlight for you in the next slide is going to change with the implementation of the aca. and the third primary option, is the city option. and here there are really two options under that option. and the first is, if a person is eligible for healthy san francisco, and they go into healthy san francisco. and so again this is a program for uninsured individuals to be eligible you have to live in san francisco. and you have to be between the ages of 18 and 64. and you have to have been uninsured for a period of time and have an income limit, but if you are eligible and not be eligible for other publicly subsidized health insurance. and so, if all of those conditions applied and then the
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person is put into healthy san francisco. and if those conditions do not apply, if the person lives outside of san francisco, or if they have health insurance through a spouse, for example, and then they are given a city medical reimburse amount account. the city medical reimbursement account works like the health reimbursement account and so they submit it after the fact and but the coverage services is what is covered under the city, mra is different than what is covered under the health reimbursement account. >> they decide what is covered and the funds revert to the employer after 24 months and the city, mra, if it is a wide variety and the city determines what is covered and it is a public benefit program and the city determines what is covered and while these funds technically revert to the city after 18 months, an individual has a right to react vait their account at any time and so technically they are available to an individual in perpetuity. >> maybe you just want to clarify the 18 months is
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after... >> after contribution? >> okay. i thought it was after no activity. >> oh, i am sorry, you are right, it is after no activity. >> okay. >> so this is, and we have changes to how these common compliance methods after the aca and the only change that you will see here is the orange box on the right-hand side called accepted benefits, or integrated hra. and so health reform says because individuals have to have minimum essential coverage, these hras don't qualify as minimum essential coverage any more and they are no longer allowed. and what is allowed, though, is a different kind of hra and a hra that does not cover those minimum essential benefits, those things like vision and dental that are not part of everyone's normal health insurance plan and so if you have an accepted benefit, hra,
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or if you are an employer and you want to provide an hra to your employees and then you can do so through an accepted benefit hra and there are limitations here, and the office of labor standards enforcement came out with guidance and i think that they may talk about later in the presentation, but, if an employer wants to provide an accepted benefit hra for an employee and they can do so for up to 24 hours, and they can do that in recognition of the fact that the vision and dental expenditures are less costly than the healthcare expenditure and the employees will not be able to use the full amount of the contribution of up to 40 hours that an individual works. and so maybe, it will be used up to 20 hours and the remainder of the employer requirement can be made with any of the other options. these two that are listed here or any other qualifying option.
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>> i thought that i would provide a little bit of data of how it works in san francisco now. this slide shows that in 2012, 4,200 covered employers made expenditures on behalf of 264,000 covered employees. and 49 percent of covered employers have fewer than 99 employees. but, 81 percent of covered employees work for businesses of this size. and the next slide, shows that the vast majority of employers healthcare expenditures are made in health insurance. and so you can see here, that the first bar is health insurance, and 90 percent of the 1.88 billion dollars that san francisco businesses reported spending on healthcare expenditures were for health insurance. and you can see that to a
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lesser extent, less than 6 percent went to health reimbursement accounts, and three percent went to the city option, and the smaller, one percent went to other health savings accounts. >> so, because hras and mras are kind of the key issue here, in the change from this, and how the aca impacts the healthcare security ordinance, i focused more on the hra issue and the accounts, that are no longer allowable under the health under the reform. and one quarter rely on the hras in 2012. and you can see here 996 employers used hr as in one way or another to comply entirely or in combination with something else. and while the smaller employers form the largest proportion of this group, all employers use the hras at an equal raise at
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25 percent of all business sizes use hras but, of those, that have hras small businesses comprise a larger proportion. >> the city option is the option that includes healthy san francisco or the medical reimbursement account, and with the aca, fewer people will be eligible for healthy san francisco, and so that means for employers complying with the healthcare security ordinance through the city option, more employees will be eligible for medical reimbursement accounts, and the reason is that healthy san francisco is not health insurance and so in order to be eligible you need to not be eligible for other publicly subsidized health insurance, many people who are eligible for healthy san francisco today will be eligible for health insurance or are eligible for
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health insurance now. right now, we have about 60,000 people in healthy san francisco, and this includes people who were enrolled through the employer and the people who enroll on their own outside of the employer arrangement and we have about 60,000 people that are in healthy san francisco and about two-thirds of them are going to be eligible for some other kind of health insurance, and then, a lesser percentage of that will actually apply. and because, just being eligible for health insurance does not get you enrolled and even today, we find that many people who are eligible for health insurance do not enroll in what they are eligible for. >> the health department wants to get as many enrolled that they qualified for. >> and so in the future, when an employer contributes to the city option on behave of an employee, if that employee is eligible for medical for the low income and then they will be required to enroll in that healthcare coverage instead a medical reimbursement account will be made for them.
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>> the good news is that allows an individual to buy health insurance, and use that money to actually buy subsidized health insurance on coverage california. >> and so you can see here, that 20 percent of all employers contributed to the city option, in 2012. and 18 percent, had or were small businesses with fewer than 50 employees, and small businesses were less likely to rely on the city option than on other methods of compliance. and this is the comparison. and so the contributions are it is same and both by the employer and meant to show the key differences between the two and so the contributions are the same and the employer contributes on behave of the employee and it meets and it has met


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